Viguier M et al. – This study questions the role of efalizumab in the induction of psoriatic arthritis (PsA). It also emphasizes the discrepancy between the courses of psoriatic skin and joint manifestations under treatment. Prospective case-control studies are needed to accurately investigate the impact of efalizumab on PsA. Methods
Study to investigate the nature of polyarthritis in pts with moderate to severe psoriasis undergoing treatment with efalizumab, a humanized anti-CD11a monoclonal antibody
Pts who developed arthritis during treatment with efalizumab were analyzed
The relationship between joint manifestations and psoriatic disease was addressed by using different classification criteria for PsA
The course of arthritis and its response to treatment were also investigated
Results
16 pts developed de novo inflammatory rheumatic disease, with a mean delay of 15 wks following the start of treatment
All pts fulfilled at least 2 different sets of classification criteria for PsA
In most of them, an improvement in skin lesions was observed at the onset of PsA, as measured using the Psoriasis Area and Severity Index
Efalizumab treatment was stopped in 11 pts and was followed by the elimination of rheumatologic symptoms in 1 patient, while 8 pts required treatment with NSAIDs with or w/o methotrexate, with 2 later being switched to TNF-α inhibitors
Reintroduction of efalizumab (2 pts) was followed by a relapse of PsA
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